Speaker Request Form
Within 24-48 hours after completing this form, Dana will contact you to go over details and availability prior to confirming that she will speak at your event/service.  If you would like a faster response and direct information, please contact Dana at thrivingforwardllc@gmail.com
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Name & Address Of Organization or Church *
Theme/ Content *
Is there a theme for your event or a them you are covering that you'd like me to stay within?
Audience *
Age range, cultural background, gender
Audience Size *
Date of The Event *
MM
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DD
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YYYY
In Person or Virtual *
Type Of Presentation *
Number Of Presentations *
Schedule *
Please include a list of dates and times for each presentation.  Please include the arrival time for sound check as well.  
Presentation Length *
What is the expected length of time for the presentation/sermon?
Technology *
If presentation is in person, please select the options that are available for the event.  
Required
Name Of Designated Contact Person *
Phone Number Of Contact Person *
Email Address Of Contact Person *
Travel Expenses *
If venue location is farther than 20 minutes,  travel expense are expected to be included.  Please select from options below which expenses will be covered.  Travel expenses are not included in honorarium.
Required
Local Airport *
Please list the nearest airport to the venue.  If your event is local, please write N/A
Proposed Honorarium *
Please note for local and virtual services the minimum requested honorarium per presentation is $200.  Details for honorarium will be discussed for events requiring more than one presentation.
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